Search results for: quality care

Authors: Inas S. Khayal, Weiping Zhou, Jonathan Skinner

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Healthcare delivery systems around the world are in crisis. The need to improve health outcomes while decreasing healthcare costs have led to an imminent call to action to transform the healthcare delivery system. While Bioinformatics and Biomedical Engineering have primarily focused on biological level data and biomedical technology, there is clear evidence of the importance of the delivery of care on patient outcomes. Classic singular decomposition approaches from reductionist science are not capable of explaining complex systems. Approaches and methods from systems science and systems engineering are utilized to structure healthcare delivery system data. Specifically, systems architecture is used to develop a multi-scale and multi-dimensional characterization of the healthcare delivery system, defined here as the Healthcare Delivery System Knowledge Base. This paper is the first to contribute a new method of structuring and visualizing a multi-dimensional and multi-scale healthcare delivery system using systems architecture in order to better understand healthcare delivery.

Keywords: health informatics, systems thinking, systems architecture, healthcare delivery system, data analytics

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Authors: Shaira Karishma Sheriff, Zarinah Hamid

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The Arab Spring, which commenced during the end of 2010 and accelerated during 2011, was caused primarily due to poverty, unemployment and a general recession in the Middle East and North African (MENA) region. The core motivation of this revolution could be said to be the need for political, economic and social reforms that the region desires to experience. Though GDP growth has been significant in the region, the income distribution mechanism in MENA countries has been ineffective. This results in low levels of education, substandard health care facilities, unemployment, and poverty. This paper argues that MENA countries have great potential for experiencing socioeconomic development by being less dependent on oil exports and enhancing their services sector through better education which would eventually lead to job creation. Furthermore, the region can encourage better trade and political integration by forming transparent and accountable governments. The notion of Nation-State needs to be addressed and the countries in the region need to look for ways to develop effective supra-national institutions for better political and economic integration that goes beyond geographical borders.

Keywords: political reforms, social reforms, economic development, nation-state, economic integration

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Authors: C. Papapicco

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Motherhood is an existential human relationship that lasts for the whole life and is always interwoven with subjectivity and culture. As a result of the brain drain, the motherhood becomes motherhood at distance. Starting from the hypothesis that re-signification of the mother at distance practices is culturally relevant; the research aims to understand the experience of mother at a distance in order to extrapolate the strategies of management of the empty nest. Specifically, the research aims to evaluate the experience of a brain drain’s mother, who created a blog that intends to take care of other parents at a distance. Actually, the blog is the only artifact symbol of the Italian culture of motherhood at distance. In the research, a Netnographic Analysis of the blog mammedicervelliinfuga.com is offered with the aim of understanding if the online world becomes an opportunity to manage the role of mother at a distance. A narrative interview with the blog creator was conducted and then the texts were analyzed by means of a Diatextual Analysis approach. It emerged that the migration projects of talented children take on different meanings and representations for parents. Thus, it is shown that the blog becomes a new form of understanding and practicing motherhood at a distance.

Keywords: brain drain, diatextual analysis, distance motherhood blog, online and offline narrations

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Authors: Omneya Messallam

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Technology has been developed dramatically in most of the educational disciplines. For instance, digital rendering subject, which is being taught in both Interior and Architecture fields, is witnessing almost annually updated software versions. A lot of students and educators argued that there will be no need for manual rendering techniques to be learned. Therefore, the Interior Design Visual Presentation 1 course (ID133) has been chosen from the first level of the Interior Design (ID) undergraduate program, as it has been taught for six years continually. This time frame will facilitate sound observation and critical analysis of the use of appropriate teaching methodologies. Furthermore, the researcher believes in the high value of the manual rendering techniques. The course objectives are: to define the basic visual rendering principles, to recall theories and uses of various types of colours and hatches, to raise the learners’ awareness of the value of studying manual render techniques, and to prepare them to present their work professionally. The students are female Arab learners aged between 17 and 20. At the outset of the course, the majority of them demonstrated negative attitude, lacking both motivation and confidence in manual rendering skills. This paper is a reflective appraisal of deploying two student-centred teaching pedagogies which are: Project-based learning (PBL) and Outcome-based education (OBE) on ID133 students. This research aims of developing some teaching strategies to enhance the quality of teaching in this given course over an academic semester. The outcome of this research emphasized the positive influence of applying such educational methods on improving the quality of students’ manual rendering skills in terms of: materials, textiles, textures, lighting, and shade and shadow. Furthermore, it greatly motivated the students and raised the awareness of the importance of learning the manual rendering techniques.

Keywords: project-based learning, outcome-based education, visual presentation, manual render, personal competences

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Authors: Devasis Ghosh

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The main hindrance to total cure of cancer is a) the failure to control continued production of cancer cells, b) its sustenance and c) its metastasis. This review study has tried to address this issue of total cancer cure in a more innovative way. A 10-pronged “CRAB METHOD”, a novel holistic scientific approach of Cancer treatment has been hypothesized in this paper. Apart from available Chemotherapy, Radiotherapy and Oncosurgery, (which shall not be discussed here), seven other points of interference and treatment has been suggested, i.e. 1. Efficient stress management. 2. Dampening of ATF3 expression. 3. Selective inhibition of Platelet Activity. 4. Modulation of serotonin production, metabolism and 5HT receptor antagonism. 5. Auxin, its anti-proliferative potential and its modulation. 6. Melatonin supplementation because of its oncostatic properties. 7. HDAC Inhibitors especially valproic acid use due to its apoptotic role in many cancers. If all the above stated seven steps are thoroughly taken care of at the time of initial diagnosis of cancer along with the available treatment modalities of Chemotherapy, Radiotherapy and Oncosurgery, then perhaps, the morbidity and mortality rate of cancer may be greatly reduced.

Keywords: ATF3 dampening, auxin modulation, cancer, platelet activation, serotonin, stress, valproic acid

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Authors: Ahmed Shaik

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Estimates are very critical in accounting and Financial Reporting cannot be complete without these estimates. There is a long list of accounting estimates that are required to be made to compute Net Income and to determine the value of assets and liabilities. To name a few, valuation of inventory, depreciation, valuation of goodwill, provision for bad debts and estimated warranties, etc. require the use of different valuation models and forecasts. Different business entities under the same industry may use different approaches to measure the value of financial items being reported in Income Statement and Balance Sheet. The disclosure notes do not provide enough details of the approach used by a business entity to arrive at the value of a financial item. Lack of details in the disclosure notes makes it difficult to compare the financial performance of one business entity with the other in the same industry. This paper is an attempt to identify the lack of enough information about accounting estimates in disclosure notes, the impact of the absence of details of accounting estimates on the comparability of financial data and financial analysis. An attempt is made to suggest the detailed disclosure while taking care of the cost and benefit of making such disclosure.

Keywords: accounting estimates, disclosure notes, financial reporting, transparency

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Authors: Sarra Kitanou

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Water recycling and reuse is an effective measure to solve the water stress problem. The sustainable use of water resource has become a national development strategy in Morocco. A key aspect of improving overall sustainability is the potential for direct wastewater effluent reuse. However, the hybrid technology membrane bioreactors (MBR) have been identified as an attractive option for producing high quality and nutrient-rich effluents for wastewater treatment. It is based on complex interactions between biological processes, filtration process and rheological properties of the liquid to be treated. Currently, with the evolution of wastewater treatment projects in Morocco, the MBR technology can be used as a technology treating different types of wastewaters and to produce effluent with suitable quality for reuse. However, the energetic consumption of this process is a great concern, which can limit the development and implementation of this technology. In this investigation, the electric energy consumption of an ultrafiltration membrane bioreactor process in domestic wastewater treatment is evaluated and compared to some MBR installations based on literature review. Energy requirements of the MBR are linked to operational parameters and reactor performance. The analysis of energy consumption shows that the biological aeration and membrane filtration are more energy consuming than the other components listed as feed and recirculation pumps. Biological aeration needs 53% of the overall energetic consumption and the specific energy consumption for membrane filtration is about 25%. However, aeration is a major energy consumer, often exceeding 50% share of total energy consumption. The optimal results obtained on the MBR process (pressure p = 1.15 bar), hydraulic retention time (15 h) showed removal efficiencies up to 90% in terms of organic compounds removal, 100% in terms of suspended solids presence and up to 80% reduction of total nitrogen and total phosphorus. The effluent from this MBR system could be considered as qualified for irrigation reuse, showing its potential application in the future.

Keywords: hybrid process, membrane bioreactor, wastewater treatment, reuse

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Authors: Sima Modirkhameneh, Mohammad Mohammadpanah

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In the process of EFL teachers’ development, self-led reflection (SLR) is thought to have an imperative role because it may help teachers analyze, evaluate, and contemplate what is happening in their classes. Such contemplations can not only enhance the quality of their instruction and provide better learning environments for learners but also improve the quality of their classroom management (CM). Accordingly, understanding the effect of teachers’ SLR practices may help us gain valuable insights into what possible modifications SLR may bring about in all aspects of EFL teachers' practitioners, especially their CM. The main purpose of this case study was, thus, to investigate the impact of SLR practices of 12 Iranian EFL teachers on their CM based on the universal classroom management checklist (UCMC). In addition, another objective of the current study was to have a clear image of EFL teachers’ perceptions of their own SLR practices and their possible outcomes. By conducting repeated reflective interviews, observations, and feedback of the participants over five teaching sessions, the researcher analyzed the outcomes qualitatively through the process of meaning categorization and data interpretation based on the principles of Grounded Theory. The results demonstrated that EFL teachers utilized SLR practices to improve different aspects of their language teaching skills and CM in different contexts. Almost all participants had positive comments and reactions about the effect of SLR on their CM procedures in different aspects (expectations and routines, behavior-specific praise, error corrections, prompts and precorrections, opportunity to respond, strengths and weaknesses of CM, teachers’ perception, CM ability, and learning process). Otherwise stated, results implied that familiarity with the UCMC criteria and reflective practices contributes to modifying teacher participants’ perceptions about their CM procedure and utilizing the reflective practices in their teaching styles. The results are thought to be valuably beneficial for teachers, teacher educators, and policymakers, who are recommended to pay special attention to the contributions as well as the complexity of reflective teaching. The study concludes with more detailed results and implications and useful directions for future research.

Keywords: classroom management, EFL teachers, reflective practices, self-led reflection

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Authors: M. Fry, L. Fitzpatrick, Julie Considine, R. Z. Shaban, Kate Curtis

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Introduction: The vast majority of older Australians lives independently and are self-managing at home, despite a growing number living with a chronic illness that requires health intervention. Evidence shows that between 50% and 80% of people presenting to the emergency department (ED) are in pain. Australian EDs manage 7.2 million attendances every year and 1.4 million of these are people aged 65 years or more. Research shows that 28% of ED patients aged 65 years or more have Cognitive impairment (CI) associated with dementia, delirium and neurological conditions. Background: Traditional ED service delivery may not be suitable for older people who present with multiple, complex and ongoing illnesses. Likewise, ED clinical staff often perceive that their role should be focused more on immediate and potential lifethreatening illness and conditions which are episodic in nature. Therefore, the needs of older people and their family/carers may not be adequately addressed in the context of an ED presentation. Aim: We aimed to explore the utilisation and characteristics of older people presenting to four metropolitan EDs. Method: The findings being presented are part of a program of research exploring pain management practices for older persons with long bone fractures. The study was conducted across four metropolitan emergency departments of older patients (65years and over) and involved a 12-month randomised medical record audit (n=255). Results: ED presentations across four ED sites in 2012 numbered 168021, with 44778 (26.6%) patients aged 65 and over. Of the 44778 patients, the average age was 79.1 years (SD 8.54). There were more females 23932 (53.5%). The majority (26925: 85.0%) of older persons self-referred to the ED and lived independently. The majority arrived by ambulance (n=18553: 41.4%) and were allocated triage category was 3 (n=19,507:43.65%) or Triage category 4 at (n=15,389: 34.43%). The top five triage symptom presentations involved pain (n=8088; 18.25%), dyspnoea (n=4735; 10.7%), falls (n=4032; 9.1%), other (n=3984; 9.0%), cardiac (n=2987; 6.7%). The top five system based diagnostic presentations involved musculoskeletal (n=8902; 20.1%), cardiac (n=6704:15.0%), respiratory (n=4933; 11.0%), neurological (n=4909; 11.0%), gastroenterology (n=4321; 9.7%). On review of one tertiary hospital database the vital signs on average at time triage: Systolic Blood Pressure 143.6mmHg. Heart Rate 83.4 beats/minute; Respiratory Rate 18.5 breaths/ minute; Oxygen saturation 97.0% and Tympanic temperature 36.7 and Blood Glucose Level 7.4mmols/litre. The majority presented with a Glasgow Coma Score of 14 or higher. On average the older person stayed in the ED 4:56 (SD 3:28minutes).The average time to be seen was 39 minutes (SD 48 minutes). The majority of older persons were admitted (n=27562: 61.5%), did not wait for treatment (n= 8879: 0.02%) discharged home (n=16256: 36.0%). Conclusion: The vast majority of older persons are living independently, although many require admission on arrival to the ED. Many arrived in pain and with musculoskeletal injuries and or conditions. New models of care need to be considered, which may better support self-management and independent living of the older person and the National Emergency Access Targets.

Keywords: chronic, older person, aged care, emergency department

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Authors: Ashkan Zakaryazad, Ekrem Duman

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A typical classification technique ranks the instances in a data set according to the likelihood of belonging to one (positive) class. A credit card (CC) fraud detection model ranks the transactions in terms of probability of being fraud. In fact, this approach is often criticized, because firms do not care about fraud probability but about the profitability or costliness of detecting a fraudulent transaction. The key contribution in this study is to focus on the profit maximization in the model building step. The artificial neural network proposed in this study works based on profit maximization instead of minimizing the error of prediction. Moreover, some studies have shown that the back propagation algorithm, similar to other gradient–based algorithms, usually gets trapped in local optima and swarm-based algorithms are more successful in this respect. In this study, we train our profit maximization ANN using the Migrating Birds optimization (MBO) which is introduced to literature recently.

Keywords: neural network, profit-based neural network, sum of squared errors (SSE), MBO, gradient descent

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Authors: Arijit Chakraborty, Anirban Roy

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The Indian peninsula is strategically located in the Asian subcontinent with the Himalayas to the North and Oceans surrounding the other three directions with annual monsoons which takes care of water supply to the rivers. The total river water discharge into the Bay of Bengal and the Arabian Sea is 628 km³/year and 274 km³/year, respectively. Thus huge volumes of fresh water meet saline water, and this mixing of two streams of dissimilar salinity gives rise to tremendous mixing energies which can be harvested for various purposes like energy generation using pressure retarded osmosis or reverse electrodialysis. The present paper concentrates on analyzing the energy of mixing for the rivers in Goa. Goa has 10 rivers of various sizes all which meet the Arabian Sea. In the present work, the 8 rivers and their salinity (NaCl concentrations) have been analyzed along with their seasonal fluctuations. Next, a Gibbs free energy formulation has been implemented to analyze the energy of mixing of the selected rivers. The highest and lowest energies according to the seasonal fluctuations have been evaluated, and this provides two important insights into (i) amount of energy that can be harvested and (ii) decision on the location of such systems.

Keywords: Gibbs energy, mixing energy, salinity gradient energy, thermodynamics

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Authors: R.T.P. De Silva, T. K. Wijayasiriwardhane, B. Jayawardena

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Most people nowadays spend their time indoor environment. Because of that, a quality indoor environment needs for them. This study was conducted to identify how to improve indoor visual comfort using a personalized light system. Light intensity, light color, glare, and contrast are the main facts that affect visual comfort. The light intensity which needs to perform a task is changed according to the task. Using necessary light intensity and we can improve the visual comfort of occupants. The hue can affect the emotions of occupants. The preferred light colors and intensity change according to the occupant's age and gender. The research was conducted to identify is there any relationship between personalization and visual comfort. To validate this designed an Internet of Things-based reading light. This light can work according to the standard light levels and personalized light levels. It also can measure the current light intensity of the environment and maintain continuous light levels according to the task. The test was conducted by using 25 undergraduates, and 5school students, and 5 adults. The feedbacks are gathered using Post-occupancy evaluation (POE) techniques. Feedbacks are gathered in three steps, It was done without any light control, with standard light level, and with personalized light level Users had to spend 10 minutes under each condition. After finishing each step, collected their feedbacks. According to the result gathered, 94% of participants rated a personalized light system as comfort for them. The feedbacks show stay under continuous light level help to keep their concentrate. Future research can be conducted on how the color of indoor light can affect for indoor visual comfort of occupants using a personalized light system. Further proposed IoT based can improve to change the light colors according to the user's preference.

Keywords: indoor environment quality, internet of things based light system, post occupancy evaluation, visual comfort

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Authors: Shahid Noor, Kazim Najjad, Muhammad Nasir, Irshad Bhutto, Abdul Samad Memon, Khurram Anwar, Tehseen Riaz, Mian Muhammad Hanif, Nauman A. Mallik, Saeed Ahmed, Israr Ahmed, Ali Yasir

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Background: Musculoskeletal pain is the most common complaint presented to the health practitioner. It is well known that untreated or under-treated pain can have a significant negative impact on an individual’s quality of life (QoL). Objectives: This study was conducted across 10 sites in six (6) major cities of Pakistan to evaluate the tolerability, safety, and the clinical response of Nuberol Forte® (Paracetamol 650 mg + Orphenadrine 50 mg) to musculoskeletal pain in routine Pakistani practice and its impact on improving the patient’s QoL. Design & Methods: This NFORT-EFFECT observational, prospective multicenter study was conducted in compliance with Good Clinical Practice guidelines and local regulatory requirements. The study sponsor was "The Searle Company Limited, Pakistan. To maintain the GCP compliances, the sponsor assigned the CRO for the site and data management. Ethical approval was obtained from an independent ethics committee. The IEC reviewed the progress of the study. Written informed consent was obtained from the study participants, and their confidentiality was maintained throughout the study. A total of 399 patients with known prescreened musculoskeletal conditions and pain who attended the study sites were recruited, as per the inclusion/exclusion criteria (clinicaltrials.gov ID# NCT04765787). The recruited patients were then prescribed Paracetamol (650 mg) and Orphenadrine (50 mg) combination (Nuberol Forte®) for 7 to 14 days as per the investigator's discretion based on the pain intensity. After the initial screening (visit 1), a follow-up visit was conducted after 1-2 weeks of the treatment (visit 2). Study Endpoints: The primary objective was to assess the pain management response of Nuberol Forte treatment and the overall safety of the drug. The Visual Analogue Scale (VAS) scale was used to measure pain severity. Secondary to pain, the patients' health-related quality of life (HRQoL) was also assessed using the Muscle, Joint Measure (MJM) scale. The safety was monitored on the first dose by the patients. These assessments were done on each study visit. Results: Out of 399 enrolled patients, 49.4% were males, and 50.6% were females with a mean age of 47.24 ± 14.20 years. Most patients were presented with Knee Osteoarthritis (OA), i.e., 148(38%), followed by backache 70(18.2%). A significant reduction in the mean pain score was observed after the treatment with the combination of Paracetamol and Orphenadrine (p<0.05). Furthermore, an overall improvement in the patient’s QoL was also observed. During the study, only ten patients reported mild adverse events (AEs). Conclusion: The combination of Paracetamol and Orphenadrine (Nuberol Forte®) exhibited effective pain management among patients with musculoskeletal conditions and also improved their QoL.

Keywords: musculoskeletal pain, orphenadrine/paracetamol combination, pain management, quality of life, Pakistani population

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Authors: Bahaa Eldin Kornah

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The organism profile for peri-prosthetic joint infection caused by hematogenous seeding or direct inoculations is changing. The organisms that cause prosthetic joint infections range from normal skin colonizers to highly virulent pathogens. The pathogens continue to evolve. While Staphylococcus aureus continues to be the leading organism, gram-negative bacilli account for approximately 7% of cases and that incidence is increasing. Methicillin-resistant S. aureus(MRSA) accounts for approximately 10% of all infections occurring in the community setting and 20% of those in the health care setting. The list of organisms causing PJI has expanded in recent years. It is important to have an understanding of which organisms may be causing a periprosthetic joint infection based on where the patient contracted it and their recent medical history. Also, recent technology has expanded rapidly and new methods to detect the pathogen and why we failed in detecting it. There are a number of explanations for the latter finding, perhaps the most important reason being the liberal use of antibiotics that interferes with the isolation of the infective organism.

Keywords: infection, periprosthetic, hip, organism profile, joint infection, joint infection

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Authors: Rossana Roila, Raffaella Branciari, Lorenzo Cardinali, David Ranucci

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The wild boar (Sus scrofa) population has strongly increased across Europe in the last decades, also causing severe fauna management issues. In central Italy, wild boar is the main hunted wild game species, with approximately 40,000 animals killed per year only in the Umbria region. The meat of the game is characterized by high-quality nutritional value as well as peculiar taste and aroma, largely appreciated by consumers. This type of meat and products thereof can meet the current consumers’ demand for higher quality foodstuff, not only from a nutritional and sensory point of view but also in relation to environmental sustainability, the non-use of chemicals, and animal welfare. The game meat production chain is characterized by some gaps from a hygienic point of view: the harvest process is usually conducted in a wild environment where animals can be more easily contaminated during hunting and subsequent practices. The definition and implementation of a certified and controlled supply chain could ensure quality, traceability and safety for the final consumer and therefore promote game meat products. According to European legislation in some animal species, such as bovine, the use of weak acid solutions for carcass decontamination is envisaged in order to ensure the maintenance of optimal hygienic characteristics. A preliminary study was carried out to evaluate the applicability of similar strategies to control the hygienic level of wild boar carcasses. The carcasses, harvested according to the selective method and processed into the game-handling establishment, were treated by nebulization with two different solutions: a 2% food-grade lactic acid solution and aromatic vinegar. Swab samples were performed before treatment and in different moments after-treatment of the carcasses surfaces and subsequently tested for Total Aerobic Mesophilic Load, Total Aerobic Psychrophilic Load, Enterobacteriaceae, Staphylococcus spp. and lactic acid bacteria. The results obtained for the targeted microbial populations showed a positive effect of the application of the lactic acid solution on all the populations investigated, while aromatic vinegar showed a lower effect on bacterial growth. This study could lay the foundations for the optimization of the use of a lactic acid solution to treat wild boar carcasses aiming to guarantee good hygienic level and safety of meat.

Keywords: game meat, food safety, process hygiene criteria, microbial population, microbial growth, food control

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Authors: Darko Prebežac, Josip Mikulić, Maja Šerić, Damir Krešić

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Camping tourism is recognized as a growing segment of the broader tourism industry, currently evolving from an inexpensive, temporary sojourn in a rural environment into a highly fragmented niche tourism sector. The trends among public-managed campgrounds seem to be moving away from rustic campgrounds that provide only a tent pad and a fire ring to more developed facilities that offer a range of different amenities, where campers still search for unique experiences that go above the opportunity to experience nature and social interaction. In addition, while camping styles and options changed significantly over the last years, coastal camping in particular became valorized as is it regarded with a heightened sense of nostalgia. Alongside this growing interest in the camping tourism, a demand for quality servicing infrastructure emerged in order to satisfy the wide variety of needs, wants, and expectations of an increasingly demanding traveling public. However, camping activity in general and quality of camping experience and campers’ satisfaction in particular remain an under-researched area of the tourism and consumption behavior literature. In this line, very few studies addressed the issue of quality product/service provision in satisfying nature based tourists and in driving their future behavior with respect to potential re-visitation and recommendation intention. The present study thus aims to investigate the drivers of positive and negative campsite experience using the case of Croatia. Due to the well-preserved nature and indented coastline, camping tourism has a long tradition in Croatia and represents one of the most important and most developed tourism products. During the last decade the number of tourist overnights in Croatian camps has increased by 26% amounting to 16.5 million in 2014. Moreover, according to Eurostat the market share of campsites in the EU is around 14%, indicating that the market share of Croatian campsites is almost double large compared to the EU average. Currently, there are a total of 250 camps in Croatia with approximately 75.8 thousands accommodation units. It is further noteworthy that Croatian camps have higher average occupancy rates and a higher average length of stay as compared to the national average of all types of accommodation. In order to explore the main drivers of positive and negative campsite experiences, this study uses principal components analysis (PCA) and an impact-asymmetry analysis (IAA). Using the PCA, first the main dimensions of the campsite experience are extracted in an exploratory manner. Using the IAA, the extracted factors are investigated for their potentials to create customer delight and/or frustration. The results provide valuable insight to both researchers and practitioners regarding the understanding of campsite satisfaction.

Keywords: Camping tourism, campsite, impact-asymmetry analysis, satisfaction

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Authors: Joyce Joas Kahembe

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The implementation of education assessment reforms in developing countries has been claimed to be problematic and difficult. The socio-economic teaching and learning environment has pointed to constraints in the education reform process. Nevertheless, there are existing assessment practices that if enhanced, can have potential to foster formative assessment practices in those contexts. The present study used the sociocultural perspective to explore teachers’ assessment practices and factors influencing them in Tanzania. Specifically, the sociocultural perspective helped to trace social, economic and political histories imparted to teachers’ assessment practices. The ethnographic oriented methods like interviews, observations and document reviews was used in this exploration. Teachers used assessment practices, such as questioning and answering, tests, assignments and examinations, for evaluating, monitoring and diagnosing students’ understanding, achievement and performance and standards and quality of instruction practices. The obtained assessment information functioned as feedback for improving students’ understanding, performance, and the standard and quality of teaching instruction and materials. For example, teachers acknowledged, praised, approved, disapproved, denied, graded, or marked students’ responses to give students feedback and aid learning. Moreover, teachers clarified and corrected or repeated students’ responses with worded/added words to improve students’ mastery of the subject content. Teachers’ assessment practices were influenced by the high demands of passing marks in the high stakes examinations and the contexts of the social economic teaching environment. There is a need to ally education assessment reforms with existing socio-economic teaching environments and society and institutional demands of assessment to make assessment reforms meaningful and sustainable. This presentation ought to contribute on ongoing strategies for contextualizing assessment practices for formative uses.

Keywords: assessment, feedback, practices, formative assessment

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Authors: Nadjat Zerf Boudjettou, Fahima Nader, Rachid Chalal

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Knowledge management is to acquire and represent knowledge relevant to a domain, a task or a specific organization in order to facilitate access, reuse and evolution. This usually means building, maintaining and evolving an explicit representation of knowledge. The next step is to provide access to that knowledge, that is to say, the spread in order to enable effective use. Knowledge management in the medical field aims to improve the performance of the medical organization by allowing individuals in the care facility (doctors, nurses, paramedics, etc.) to capture, share and apply collective knowledge in order to make optimal decisions in real time. In this paper, we propose a knowledge management approach based on integration technique of heterogeneous data in the medical field by creating a data warehouse, a technique of extracting knowledge from medical data by choosing a technique of data mining, and finally an exploitation technique of that knowledge in a case-based reasoning system.

Keywords: data warehouse, data mining, knowledge discovery in database, KDD, medical knowledge management, Bayesian networks

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Authors: Natividad Natalia Angeles Manuel

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In the Dominican Republic, American-Dominican veterans face unique challenges due to their dual identities and wartime experiences. This case study examines an 85-year-old veteran with memory impairments and emotional distress linked to military service. A neuropsychological assessment using standardized tools evaluated cognitive domains and functional abilities. Significant deficits in memory, orientation, semantic memory, and executive functions, alongside symptoms of Post-Traumatic Stress Disorder and depression, were identified. A six-month cognitive stimulation program included tailored interventions to enhance memory, attention, and executive skills through weekly sessions and group activities. Medical and physical therapy support aimed to improve overall cognitive, functional, and emotional outcomes. Follow-up evaluations showed improvements in memory retention, attention, task proficiency, and reduced depressive symptoms, highlighting the program's effectiveness in promoting emotional well-being and quality of life. Despite ongoing memory challenges and military-related nightmares, the veteran responded positively to interventions, demonstrating resilience and motivation. This study emphasizes the importance of personalized neuropsychological interventions for American-Dominican veterans in the Dominican Republic. Through assessment tools and focused cognitive stimulation strategies, healthcare providers can successfully alleviate cognitive and emotional challenges stemming from traumatic experiences in elderly veterans. Overall, integrated neuropsychological assessment and stimulation programs are shown to enhance cognitive resilience and emotional well-being, thus contributing to an enhanced quality of life for aging American-Dominican veterans.

Keywords: neuropsychology, cognitive stimulation, American-Dominican veterans, Dominican Republic, PTSD, memory deficits

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Authors: Norbert Magyar, Jozsef Kovacs, Peter Tanos, Balazs Trasy, Tamas Garamhegyi, Istvan Gabor Hatvani

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Water is one of the most important common resources, and as a result of urbanization, agriculture, and industry it is becoming more and more exposed to potential pollutants. The prevention of the deterioration of water quality is a crucial role for environmental scientist. To achieve this aim, the operation of monitoring networks is necessary. In general, these networks have to meet many important requirements, such as representativeness and cost efficiency. However, existing monitoring networks often include sampling sites which are unnecessary. With the elimination of these sites the monitoring network can be optimized, and it can operate more economically. The aim of this study is to illustrate the applicability of the CCDA (Combined Cluster and Discriminant Analysis) to the field of water quality monitoring and optimize the monitoring networks of a river (the Danube), a wetland-lake system (Kis-Balaton & Lake Balaton), and two surface-subsurface water systems on the watershed of Lake Neusiedl/Lake Fertő and on the Szigetköz area over a period of approximately two decades. CCDA combines two multivariate data analysis methods: hierarchical cluster analysis and linear discriminant analysis. Its goal is to determine homogeneous groups of observations, in our case sampling sites, by comparing the goodness of preconceived classifications obtained from hierarchical cluster analysis with random classifications. The main idea behind CCDA is that if the ratio of correctly classified cases for a grouping is higher than at least 95% of the ratios for the random classifications, then at the level of significance (α=0.05) the given sampling sites don’t form a homogeneous group. Due to the fact that the sampling on the Lake Neusiedl/Lake Fertő was conducted at the same time at all sampling sites, it was possible to visualize the differences between the sampling sites belonging to the same or different groups on scatterplots. Based on the results, the monitoring network of the Danube yields redundant information over certain sections, so that of 12 sampling sites, 3 could be eliminated without loss of information. In the case of the wetland (Kis-Balaton) one pair of sampling sites out of 12, and in the case of Lake Balaton, 5 out of 10 could be discarded. For the groundwater system of the catchment area of Lake Neusiedl/Lake Fertő all 50 monitoring wells are necessary, there is no redundant information in the system. The number of the sampling sites on the Lake Neusiedl/Lake Fertő can decrease to approximately the half of the original number of the sites. Furthermore, neighbouring sampling sites were compared pairwise using CCDA and the results were plotted on diagrams or isoline maps showing the location of the greatest differences. These results can help researchers decide where to place new sampling sites. The application of CCDA proved to be a useful tool in the optimization of the monitoring networks regarding different types of water bodies. Based on the results obtained, the monitoring networks can be operated more economically.

Keywords: combined cluster and discriminant analysis, cost efficiency, monitoring network optimization, water quality

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Authors: Hiroko Komatsu, Kaori Yagasaki

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Background: Cancer-related cognitive impairment is a common problem seen in cancer patients undergoing chemotherapy. Physical activity may show beneficial effects on the cognitive function in such patients. Therefore, we have developed a self-directed home yoga program for cancer patients with cognitive symptoms during chemotherapy. This program involves a DVD presenting a combination of yoga courses based on patient preferences to be practiced at home. This study was performed to examine the feasibility of this program. In addition, we also examined changes in cognitive function and quality of life (QOL) in these patients participating in the program. Methods: This prospective feasibility study was conducted in a 500-bed general hospital in Tokyo, Japan. The study population consisted of breast cancer patients undergoing chemotherapy as the initial therapy. This feasibility study used a convenience sample with estimation of recruitment rate in a single facility with the availability of trained nurses and physicians to ensure safe yoga intervention. The aim of the intervention program was to improve cognitive function by means of both physical and mental activation via yoga, consisting of physical practice, breathing exercises, and meditation. Information on the yoga program was provided as a booklet, with an instructor-guided group yoga class during the orientation, and a self-directed home yoga program on DVD with yoga logs. Results: The recruitment rate was 44.7%, and the study population consisted of 18 women with a mean age of 43.9 years. This study showed high rates of retention, adherence, and acceptability of the yoga program. Improvements were only observed in the cognitive aspects of fatigue, and there were serious adverse events during the program. Conclusion: The self-directed home yoga program discussed here was both feasible and safe for breast cancer patients showing cognitive symptoms during chemotherapy. The patients also rated the program as useful, interesting, and satisfactory. Participation in the program was associated with improvements in cognitive fatigue but not cognitive function.

Keywords: yoga, cognition, breast cancer, chemotherapy, quality of life

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Authors: Debora C. Mendes, Matthias Eckert, Claudia S. Moço, Helio Martins, Jean-Pierre Gonçalves, Miguel Oliveira, Jose P. Da Silva

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Disposal of construction and demolition waste (C&DW) in embankments in the periphery of cities causes both environmental and social problems. To achieve the management of C&DW, a detailed analysis of the properties of these materials should be done. In this work we report a comparative study of the physical, chemical and environmental properties of natural and C&DW aggregates from 25 different origins. Assays were performed according to European Standards. Analysis of heavy metals and organic compounds, namely polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs), were performed. Finally, properties of concrete prepared with C&DW aggregates are reported. Physical analyses of C&DW aggregates indicated lower quality properties than natural aggregates, particularly for concrete preparation and unbound layers of road pavements. Chemical properties showed that most samples (80%) meet the values required by European regulations for concrete and unbound layers of road pavements. Analyses of heavy metals Cd, Cr, Cu, Pb, Ni, Mo and Zn in the C&DW leachates showed levels below the limits established by the Council Decision of 19 December 2002. Identification and quantification of PCBs and PAHs indicated that few samples shows the presence of these compounds. The measured levels of PCBs and PAHs are also below the limits. Other compounds identified in the C&DW leachates include phthalates and diphenylmethanol. The characterized C&DW aggregates show lower quality properties than natural aggregates but most samples showed to be environmentally safe. A continuous monitoring of the presence of heavy metals and organic compounds should be made to trial safe C&DW aggregates. C&DW aggregates provide a good economic and environmental alternative to natural aggregates.

Keywords: concrete preparation, construction and demolition waste, heavy metals, organic pollutants

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Authors: Mubarak Saadu Nabunkari, Abdullahi Abdu Ibrahim, Muhammad Ilyas

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This study looks at how Internet of Things (IoT) devices are used in healthcare to monitor and treat patients better. However, using these devices in healthcare comes with security problems. The research explores using Security Information and Event Management (SIEM) systems with healthcare IoT devices to solve these security challenges. Reviewing existing literature shows the current state of IoT security and emphasizes the need for better protection. The main worry is that healthcare IoT devices can be easily hacked, putting patient data and device functionality at risk. To address this, the research suggests a detailed security framework designed for these devices. This framework, based on literature and best practices, includes important security measures like authentication, data encryption, access controls, and anomaly detection. Adding SIEM systems to this framework helps detect threats in real time and respond quickly to incidents, making healthcare IoT devices more secure. The study highlights the importance of this integration and offers guidance for implementing healthcare IoT securely, efficiently, and effectively.

Keywords: cyber security, threat intelligence, forensics, heath care

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Authors: Catarina Isabel Ramos Pereira, Jorge Machado, Begona Alonso Criado, Maria João Santos

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Introduction: Gait disorders are one of the symptoms that have severe implications on the quality of life in Parkinson's disease (PD). Currently, there is no therapy to reverse or treat this condition. None of the drugs used in conventional medical treatment is entirely efficient, and all have a high incidence of side effects. Acupuncture treatment is believed to improve motor ability, but there is still little scientific evidence in individuals with PD. Aim: The aim of the study is to investigate the acute effect of acupuncture on gait parameters in Parkinson's disease. Methods: This is a randomized and controlled crossover study. The same individual patient was part of both the experimental (real acupuncture) and control group (false acupuncture/sham), and the sequence was randomized. Gait parameters were measured at two different moments, before and after treatment, using four force platforms as well as the collection of 3D markers positions taken by 11 cameras. Images were quantitatively analyzed using Qualisys Track Manager software that let us extract data related to the quality of gait and balance. Seven patients with the diagnosis of Parkinson's disease were included in the study. Results: Statistically significant differences were found in gait speed (p = 0.016), gait cadence (p = 0.006), support base width (p = 0.0001), medio-lateral oscillation (p = 0.017), left-right step length (p = 0.0002), and stride length: right-right (p = 0.0000) and left-left (p = 0.0018), time of left support phase (p = 0.029), right support phase (p = 0.025) and double support phase (p = 0.015), between the initial and final moments for the experimental group. Differences in right-left stride length were found for both groups. Conclusion: Our results show that acupuncture could enhance gait in Parkinson's disease patients. Deep research involving a larger number of volunteers should be accomplished to validate these encouraging findings.

Keywords: acupuncture, traditional Chinese medicine, Parkinson's disease, gait

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Authors: Joana Margarida Bôto, Belmira Neto, Vera Miguéis, Manuela Meireles, Ada Rocha

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The Mediterranean diet has been recognized as a sustainable model of living with benefits for the environment and human health. However, a complete assessment of its sustainability, encompassing all dimensions and aspects, to our best knowledge, has not yet been realized. This systematic literature review aimed to fill this gap by identifying and describing the indicators used to assess the sustainability of the Mediterranean diet, looking at several dimensions, and presenting the results from their application. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines methodology was used, and searches were conducted in PubMed, Scopus, Web of Science, and GreenFile. There were identified thirty-two articles evaluating the sustainability of the Mediterranean diet. The environmental impact was quantified in twenty-five of these studies, the nutritional quality was evaluated in seven studies, and the daily cost of the diet was assessed in twelve studies. A total of thirty-three indicators were identified and separated by four dimensions of sustainability, specifically, the environmental dimension (ten indicators, namely carbon, water, and ecological footprint), the nutritional dimension (eight indicators, namely Health score and Nutrient Rich Food Index), the economic dimension (one indicator, the dietary cost), the sociocultural dimension (six indicators – with no results). Only eight of the studies used combined indicators. The Mediterranean diet was considered in all articles as a sustainable dietary pattern with a lower impact than Western diets. The carbon footprint ranged between 0.9 and 6.88 kg CO₂/d per capita, the water footprint between 600 and 5280 m³/d per capita, and the ecological footprint between 2.8 and 53.42 m²/d per capita. The nutritional quality was high, obtaining 122 points using the Health score and 12.95 to 90.6 points using the Nutrient Rich Food Index. The cost of the Mediterranean diet did not significantly differ from other diets and varied between 3.33 and 14.42€/d per capita. A diverse approach to evaluating the sustainability of the Mediterranean diet was found.

Keywords: Mediterranean diet, sustainability, environmental indicators, nutritional indicators

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Authors: Moira Cordiner

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As a result of an Australian university approving a policy to improve the quality of assessment practices, as an academic developer (AD) with expertise in criterion-referenced assessment commenced in 2008. The four-year appointment was to support 40 'champions' in their Schools. This presentation is based on the experiences of a group of Chemistry academics who worked with the AD to develop and implement an honours dissertation rubric. Honours is a research year following a three-year undergraduate year. If the standard of the student's work is high enough (mainly the dissertation) then the student can commence a PhD. What became clear during the process was that much more was at stake than just the successful development and trial of the rubric, including academics' reputations, university rankings and research outputs. Working with the champion-Head of School(HOS) and the honours coordinator, the AD helped them adapt an honours rubric that she had helped create and trial successfully for another Science discipline. A year of many meetings and complex power plays between the two academics finally resulted in a version that was critiqued by the Chemistry teaching and learning committee. Accompanying the rubric was an explanation of grading rules plus a list of supervisor expectations to explain to students how the rubric was used for grading. Further refinements were made until all staff were satisfied. It was trialled successfully in 2011, then small changes made. It was adapted and implemented for Medicine honours with her help in 2012. Despite coming to consensus about statements of quality in the rubric, a few academics found it challenging matching these to the dissertations and allocating a grade. They had had no time to undertake training to do this, or make overt their implicit criteria and standards, which some admitted they were using - 'I know what a first class is'. Other factors affecting grading included: the small School where all supervisors knew each other and the students, meant that friendships and collegiality were at stake if low grades were given; no external examiners were appointed-all were internal with the potential for bias; supervisors’ reputations were at stake if their students did not receive a good grade; the School's reputation was also at risk if insufficient honours students qualified for PhD entry; and research output was jeopardised without enough honours students to work on supervisors’ projects. A further complication during the study was a restructure of the university and retrenchments, with pressure to increase research output as world rankings assumed greater importance to senior management. In conclusion, much more was at stake than developing a usable rubric. The HOS had to be seen to champion the 'new' assessment practice while balancing institutional demands for increased research output and ensuring as many honours dissertations as possible met high standards, so that eventually the percentage of PhD completions and research output rose. It is therefore in the institution's best interest for this cycle to be maintained as it affects rankings and reputations. In this context, are rubrics redundant?

Keywords: explicit and implicit standards, judging quality, university rankings, research reputations

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Authors: S. Fata, M. A. Tokat, N. Bagardi, B. Yilmaz

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Nowadays, various traditional practices are used throughout the world with aim to improve fertility. Various traditional remedies, acupuncture, religious practices such as sacrifice are frequently used. Studies often evaluate the traditional practices used by the women. But the use of this non-medical practice by couples and specific application reasons of this methods has been less investigated. The aim of this study was to evaluate the common used non-medical practices and determine perceived benefits by couples with fertility problems in Turkey. This is a descriptive study. Research data were collected between May-July 2016, in Izmir Ege Birth Education and Research Hospital Assisted Reproduction Clinic, from 151 couples with fertility problem. Personal Information Form and Non-Medical Practices Used for Fertility Evaluation Form was used. Number 'GOA 2649' permission letter from Dokuz Eylul University Non-Invasive Research Ethics Board, permission letter from the institution and the written consent from participants has been received to carry out the study. In the evaluation of the data, frequencies and proportions analysis were used. The average age of women participating in the study was 32.87, the 35.8% were high school graduates, 60.3% were housewife and the 58.9% lived in city. The 30.5% of husbands were high school graduates, the 96.7% were employed and the 60.9% lived in city. The 78.1% of couples lived as a nuclear family, the average marriage year was 7.58, in 33.8% the fertility problem stems from women, 42.4% of them received a diagnosis for 1-2 years, 35.1% were being treated for 1-2 years. The 35.8% of women reported use of non-medical applications. The 24.4% of women used figs, onion cure, hacemat, locust, bee-pollen milk, the 18.2% used herbs, the 13.1% vowed, the 12.1% went to the tomb, the 10.1% did not bath a few days after the embryo transfer, the 9.1% used thermal water baths, the 5.0% manually corrected the womb, the 5.0% printed amulets by Hodja, the 3.0% went to the Hodja/pilgrims. Among the perceived benefits of using non-medical practices; facilitate pregnancy and implantation, improve oocyte quality were the most recently expressed. Women said that they often used herbs to develop follicles, did not bath after embryo transfer with aim to provide implantation, and used thermal waters to get rid of the infection. Compared to women, only the 25.8% of men used the non-medical practice. The 52.1% reported that they used peanuts, hacemat, locust, bee-pollen milk, the 14.9% used herbs, the 12.8% vowed, the 10.1% went to the tomb, the 10.1% used thermal water baths. Improve sperm number, motility and quality were the most expected benefits. Men said that they often used herbs to improve sperm number, used peanuts, hacemat, locust, bee-pollen milk to improve sperm motility and quality. Couples in Turkey often use non-medical practices to deal with fertility problems. Some of the practices considered as useful can adversely affect health. Healthcare providers should evaluate the use of non-medical practices and should inform if the application is known adverse effects on health.

Keywords: fertility, couples, non-medical practice, perceived benefit

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Authors: Aneesh Mathew, Arunab K. S., Atul Kumar Sharma

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The uncontrolled rise in population has led to unplanned, swift, and unsustainable urban expansion, causing detrimental environmental impacts on both local and global ecosystems. This research delves into a comprehensive examination of the Urban Heat Island (UHI) phenomenon in Bengaluru and Hyderabad, India. It centers on the spatial and temporal distribution of UHI and its correlation with air pollutants. Conducted across summer and winter seasons from 2001 to 2021 in Bangalore and Hyderabad, this study discovered that UHI intensity varies seasonally, peaking in summer and decreasing in winter. The annual maximum UHI intensities range between 4.65 °C to 6.69 °C in Bengaluru and 5.74 °C to 6.82 °C in Hyderabad. Bengaluru particularly experiences notable fluctuations in average UHI intensity. Introducing the Urban Thermal Field Variance Index (UTFVI), the study indicates a consistent strong UHI effect in both cities, significantly impacting living conditions. Moreover, hotspot analysis demonstrates a rising trend in UHI-affected areas over the years in Bengaluru and Hyderabad. This research underscores the connection between air pollutant concentrations and land surface temperature (LST), highlighting the necessity of comprehending UHI dynamics for urban environmental management and public health. It contributes to a deeper understanding of UHI patterns in swiftly urbanizing areas, providing insights into the intricate relationship between urbanization, climate, and air quality. These findings serve as crucial guidance for policymakers, urban planners, and researchers, facilitating the development of innovative, sustainable strategies to mitigate the adverse impacts of uncontrolled expansion while promoting the well-being of local communities and the global environment.

Keywords: urban heat island effect, land surface temperature, air pollution, urban thermal field variance index

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Authors: Benjamin Castillo, Luis Pastenes, Fernando Cordova

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The pathogen growth in animal source foods is a common problem in the food industry, causing monetary losses due to the spoiling of products or food intoxication outbreaks in the community. In this sense, the quality of the product is reflected by the population of deteriorating agents present in it, which are mainly bacteria. The factors which are likely associated with freshness in animal source foods are temperature and processing, storage, and transport times. However, the level of deterioration of products depends, in turn, on the characteristics of the bacterial population, causing the decomposition or spoiling, such as pH level and toxins. Knowing the growth dynamics of the agents that are involved in product contamination allows the monitoring for more efficient processing. This means better quality and reasonable costs, along with a better estimation of necessary time and temperature intervals for transport and storage in order to preserve product quality. The objective of this project is to design a secondary model that allows measuring the impact on temperature bacterial growth and the competition for pH adequacy and release of bacteriocins in order to describe such phenomenon and, thus, estimate food product half-life with the least possible risk of deterioration or spoiling. In order to achieve this objective, the authors propose an analysis of a three-dimensional ordinary differential which includes; logistic bacterial growth extended by the inhibitory action of bacteriocins including the effect of the medium pH; change in the medium pH levels through an adaptation of the Luedeking-Piret kinetic model; Bacteriocin concentration modeled similarly to pH levels. These three dimensions are being influenced by the temperature at all times. Then, this differential system is expanded, taking into consideration the variable temperature and the concentration of pulsed bacteriocins, which represent characteristics inherent of the modeling, such as transport and storage, as well as the incorporation of substances that inhibit bacterial growth. The main results lead to the fact that temperature changes in an early stage of transport increased the bacterial population significantly more than if it had increased during the final stage. On the other hand, the incorporation of bacteriocins, as in other investigations, proved to be efficient in the short and medium-term since, although the population of bacteria decreased, once the bacteriocins were depleted or degraded over time, the bacteria eventually returned to their regular growth rate. The efficacy of the bacteriocins at low temperatures decreased slightly, which equates with the fact that their natural degradation rate also decreased. In summary, the implementation of the mathematical model allowed the simulation of a set of possible bacteria present in animal based products, along with their properties, in various transport and storage situations, which led us to state that for inhibiting bacterial growth, the optimum is complementary low constant temperatures and the initial use of bacteriocins.

Keywords: bacterial growth, bacteriocins, mathematical modelling, temperature

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Authors: Alberto Piatto, Zaza Nadja Lee Hansen, Peter Jacobsen

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This paper examines the quantitative and qualitative factors influencing the buyer-supplier relationship. Understanding and acting on the right factors influencing supplier relationship management is crucial when a company outsource an important part of its business as it can be for engineering to order (ETO) company executing only the designing part in-house. Acting on these factors increase the quality of the relationship obtaining for both parties what they want and expect from an improved relationship. Best practices in supplier relationship management are considered and a case study of a large global company, called Cement A/S, operating in the cement business is carried out. One study is conducted including a large international company and hundreds of its suppliers. Data from the company is collected using semi-structured interviews and data from the suppliers is collected using a survey. Based on these inputs and an extensive literature review a classification of factors influencing the relationship buyer-supplier is presented and discussed. The results show that different managers among the company are assessing supplier from various perspectives, a standard approach to measure the performance of suppliers does not exist. The factors used nowadays in the company to measure performances of the suppliers are mostly related to time and cost. Quality is a key factor, but it has not been addressed properly since no data are available in the system. From a practical perspective, managers can learn from this paper which factors to consider when applying best practices of Supplier Relationship Management. Furthermore, from a theoretical perspective, this paper contributes with new knowledge in the area as limited research in collaboration with the company has been conducted. For this reason, a company, its suppliers and few studies for this type of industry have been conducted. For further research, it is suggested to define the correlation of factors to the profitability of the company and calculate its impact. When conducting this analysis it is important to focus on the efficient and effective use of factors that can be measurable and accepted from the supplier.

Keywords: buyer-supplier relationship, cement industry, classification of factors, ETO

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